• Fran A Hardaway, Ahmed M Raslan, and Kim J Burchiel.
• Department of Neurological Surgery, Oregon Health & Sciences University, Portland, Oregon.
• Neurosurgery. 2018 Sep 1; 83 (3): 540-547.

BackgroundInfection is one of the most common complications of deep brain stimulation (DBS). Long-term infection rates beyond the immediate postoperative period are rarely evaluated.ObjectiveTo study short- and long-term DBS-related infection rates; to evaluate any potential seasonality associated with DBS-related infections.MethodsWe retrospectively reviewed all DBS surgeries performed in a 5-yr period at 1 hospital by a single surgeon. Infection rates and clinical characteristics were analyzed. Postoperative "infections" were defined as occurring within 6 mo of implantation of DBS hardware, while "erosions" were defined as transcutaneous exposure of hardware at ≥6 mo after implantation. Based on the date of surgery preceding an infection, rates of infection were calculated on a monthly and seasonal basis and compared using Chi square and logistic regression analyses.ResultsA total of 443 patients underwent 592 operations; 311 patients underwent primary DBS placement with 632 electrodes. Primary DBS placement infection incidence was 2.6%. DBS procedure infection and infection rate by electrode were 2.9% and 3.2%, respectively. Infectious complications presented later than 6 mo postoperatively in 38% of infected patients Summer (July-September) infection rate was significantly higher than other seasons (P = .002). The odds ratio of an infection related to a surgery performed in August was found to be 4.15 compared to other months (P = .021).ConclusionThere is a persistent risk of DBS infection and erosion beyond the first year of DBS implantation. Start of the academic year was associated with increased infection rate at our institution.

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